The cardioSCORE is presented as a single numerical score based on the levels of apolipoprotein A1, apolipoprotein B, beta-2 microglobulin, carcinoembryonic antigen, high sensitivity C-reactive protein, lipoprotein(a), and transferrin.

Participants had a mean age of 69 and were followed for 2.4 years.

Biomarkers Help Reclassify CV Risk

In a second study of cardioSCORE, researchers reported that the novel panel of biomarkers improved risk classification for near-term cardiovascular events.

The study comprised 6,808 asymptomatic adults with a mean age of 69, and 44% of them men.

When researchers adjusted for traditional risk factors, the hazard ratio associated with the coronary artery calcium score was 1.18 (95% CI 1.11 to 1.25). The corresponding hazard ratio for carotid plaque burden by ultrasound was 1.63 (95% CI 1.31 to 2.05) and for the investigational cardioSCORE (BG Medicine), it was 1.32 (95% CI 1.21 to 1.44).

The addition of cardioSCORE to traditional risk factors, along with calcium score and carotid plaque burden, resulted in a higher net reclassification improvement, said Khurram Nasir, MD, MPH, of Baptist Health South Florida in Coral Gables, and colleagues at the AHA meeting.

Researchers breaking down HDL cholesterol into subfractions found that those in the lowest tertile of HDL3 cholesterol had a 50% relative increase in mortality 2 years after hospitalization for acute MI compared with the middle tertile.

HDL2, a larger, more buoyant molecule than the smaller, denser HDL3, was nonsignificantly associated with mortality risk, reported Seth S. Martin, MD, of Johns Hopkins Hospital in Baltimore, and colleagues at the AHA meeting.

Researchers analyzed data from 2,465 patients from the TRIUMPH prospective multicenter registry, which includes 24 U.S. centers.

With an average age of 58, patients did not show a significant increase in death associated with the lowest tertile of total HDL cholesterol (10.9%) compared with the middle (8.2%) and highest ( 8.5%) tertiles.

Researchers, who used the VAP Lipid Panel (Atherotech), concluded that determining the subfractions of HDL-C has value for risk stratification.

Young Women Have Atypical MI Pain

The VIRGO study, which included about 2,000 women between ages 18 and 55, found that younger women attribute chest pain to a noncardiac cause more often than men do, researchers found.

Women more than men had significantly more radiating pain, indigestion or nausea, shortness of breath, and palpitations (P<0.01) according to Judith Lichtman, PhD, MPH, of Yale University School of Public Health, and colleagues who reported the study at the AHA meeting.

When men attributed their chest pain to noncardiac causes they more often cited indigestion or muscle pain, where women more often cited indigestion or stress/anxiety.

Women also were less likely to seek care because of concern about heart disease (41% to 49%, P<0.001).

Afib: There's an App for That

An iPhone app that sends a high-quality single-lead ECG to a server might be ideal for community screening programs, according to an AHA study.

Jarrett Lau, MBBS, from Concord Hospital in Sydney, Australia, and colleagues tested the app in 109 patients, 70 of whom were in sinus rhythm and 39 in atrial fibrillation.

The ECG is recorded and sent to a server (AliveCor), which identifies the rhythm as either normal or Afib. The app diagnosis was compared with a cardiologist diagnosing the ECG sent by the iPhone and a cardiologist reading a 12-lead ECG.

The sensitivity and specificity for Afib diagnosis for all three were as follows:

Automatic app: 100% and 90%

Cardiologist reading the app data: 95% and 94%

Cardiologist reading the 12-lead ECG: 87% and 97%

Researchers tweaked the app for optimization and improved the sensitivity, specificity, and overall accuracy to 100%, 96%, and 97%.

More ICD Complications for Women

An analysis of a national database revealed that women who received an implantable cardioverter defibrillator for primary prevention have higher rates of readmission for heart failure and mortality at 6-months than men.

Of the 38,912 patients in the NCDR ICD Registry, 25% were women. Compared to men, women had significantly more complications, death, and readmissions at 30 or 90 days as well as 6 months (P<0.001), according to Andrea Russo, MD, of Cooper University Hospital in Camden, N.J., and colleagues.

After researchers adjusted for baseline characteristics, they found the odds ratio for differences in complications or mortality to be 1.40 (95% CI 1.27 to 1.54, P<0.001), and heart failure readmission was 1.34 (94% CI 1.25 to 1.44, P<0.001), they reported at the AHA meeting.

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